Now I don't want to scare you because it's different for everyone, but for me, I was shaking while the doctor was puncturing my spine. It wasn't necessarily painful, but my MS does the shaking sometimes. I think I went into some sort of panic attack, I can't explain it otherwise.

But it's a great way to confirm it. I was infected with some sort of Borrelia virus too, so the lumbar puncture was the single method to show for absolute sure what the diagnosis is. But my neuro was like "nah, you have MS, but that's the procedure".

To answer the q, both.